Shipper
Consignee
Air Waybill No.
Page of Pages
WARNING
Failure to comply in all respects with the applicable Dangerous Goods Regulations may be in breach of the applicable law, subject to legal penalties.
Two completed and signed copies of this Declaration must be handed to the operator.
TRANSPORT DETAILSThis shipment is within the limitationsprescribed for:
(delete non-applicable )
Airport of Departure (optional):
PASSENGER ANDCARGO AIRCRAFT
CARGOAIRCRAFT ONLY
Shipment type: (delete non-applicable)
NON-RADIOACTIVE RADIOACTIVEAirport of Destination (optional):
NATURE AND QUANTITY OF DANGEROUS GOODSUN Number or Identification Number, Proper Shipping Name, Class or Division (subsidiary hazard), Packing Group (if required) and all other required information.
Additional Handling Information
I hereby declare that the contents of this consignment are fully and accuratelydescribed above by the proper shipping name, and are classified, packagedmarked and labelled/placarded, and are in all respects in proper condition fortransport according to applicable international and national governmentalregulations. I declare that all of the applicable air transport requirements havebeen met.
Name of Signatory
Date
Signature (See warning above)
SHIPPER’S DECLARATION FOR DANGEROUS GOODS
Shipper’s Reference No.(optional)
